• Litigated Claims Consultant /Examiner,…

    Sedgwick (Southfield, MI)
    …Work(R) Fortune Best Workplaces in Financial Services & Insurance Litigated Claims Consultant /Examiner, Pooling (Hybrid) **Are you looking for an impactful job in an ... global company known for its excellence and customer service. + Take advantage of a variety of professional development opportunities that help you perform… more
    Sedgwick (05/08/25)
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  • Senior Clinical Operations Compliance…

    Medical Mutual of Ohio (OH)
    …offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Acts as ... matter expert and collaborates with various internal departments to ensure that Medicare Advantage (MA) clinical programs and regulatory reporting are compliant… more
    Medical Mutual of Ohio (04/15/25)
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  • Market CMO, Medical-IN

    CenterWell (Louisville, KY)
    …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
    CenterWell (05/16/25)
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  • Primary Care Physician

    ChenMed (Cleveland, OH)
    …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
    ChenMed (06/19/25)
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  • Primary Care Physician

    ChenMed (Richmond, VA)
    …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
    ChenMed (04/10/25)
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  • Nurse Practitioner

    ChenMed (Philadelphia, PA)
    …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
    ChenMed (05/10/25)
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  • Hematology Oncology Physician

    Provider Solutions & Development (Walla Walla, WA)
    …southeast Washington. A Level III trauma center, Providence St. Mary has a five-star quality rating from the Centers for Medicare and Medicaid Services. With its ... a large research network, and opportunities for investigator-initiated trials. Take advantage of all these professional growth opportunities while enjoying life in… more
    Provider Solutions & Development (06/16/25)
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  • Associate Director, RN Medical Management Services

    Banner Health (AZ)
    …Your responsibilities will also include assisting the Director RN with audits for Medicare Advantage plans and commercial insurance plans. **Must have case ... optimal clinical, operational, financial, and satisfaction outcomes. Acts as a consultant within the organization and community. 6. Analyzes data and healthcare… more
    Banner Health (06/07/25)
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